Annals Of Work Exposures and Health最新文献

{"title":"Investigating antineoplastic drug surface contamination in veterinary settings and on canine patients.","authors":"Andrew Floeder, Jingfang Huang, Kelly Bergsrud, Rachael Lilly, Antonella Borgatti, Susan Arnold, Silvia Balbo","doi":"10.1093/annweh/wxaf058","DOIUrl":"10.1093/annweh/wxaf058","url":null,"abstract":"<p><p>Antineoplastic drugs can persist on surfaces in human and veterinary oncology clinics where they are administered, resulting in potentially hazardous exposures for healthcare workers and cancer patient caregivers. To assess potential surface contamination in occupational settings, a new liquid chromatography-selected reaction monitoring-mass spectrometry (LC-SRM-MS/MS) method was developed to simultaneously detect six commonly used antineoplastic drugs. A surface wipe and desorption method was optimized for cyclophosphamide, doxorubicin, methotrexate, etoposide, paclitaxel, and 5-fluorouracil with drug desorption recoveries ranging from 49% to 79%. The limit of detection (LOD) and limit of quantitation (LOQ) ranged from 0.01 to 0.12 ng/ml and 0.01 to 1.33 ng/ml, respectively. This method was used to quantify cyclophosphamide and doxorubicin surface contamination from wipe samples collected at a veterinary clinic following drug administration to canine-patients. Specific areas in the oncology treatment room identified as frequently contacted were sampled to determine the antineoplastic drug surface contamination that could lead to worker exposure through dermal contact, with cyclophosphamide and doxorubicin levels ranging from 6.68 to 17.4 pg cm-2 and 13.5 to 40.3 pg cm-2. Additionally, cyclophosphamide and doxorubicin wipe samples (n = 50) were obtained from two kennel surfaces and 10 canine-patients after chemotherapy. Samples were collected from the patients' coats before leaving the clinic and day after in the home environment to investigate the potential for dogs to be a source of household contamination. Cyclophosphamide was identified in samples collected at home in 4/5 canine-patients at levels ranging from 2.61 to 368 ng/sample, while doxorubicin was identified on kennel surfaces wiped post-treatment at levels ranging from 3.53 to 1655 pg cm-2. These findings support the ability of this method to detect contamination of these drugs in both occupational clinics and homes. The results set the stage for investigating contamination levels in various settings, such as human and veterinary clinics and home environments, as well as evaluating the effectiveness of decontamination products and protocols toward reducing workplace and environmental exposures.</p>","PeriodicalId":8362,"journal":{"name":"Annals Of Work Exposures and Health","volume":" ","pages":"843-854"},"PeriodicalIF":2.1,"publicationDate":"2025-09-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144999546","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Overview of historical formaldehyde occupational exposure in China.","authors":"Jia Nie, Calvin B Ge, Nathaniel Rothman, Wei Hu, Qing Lan, Roel Vermeulen, Susan Peters","doi":"10.1093/annweh/wxaf037","DOIUrl":"10.1093/annweh/wxaf037","url":null,"abstract":"<p><strong>Objectives: </strong>Formaldehyde is a known human carcinogen related to leukemia and nasopharyngeal cancer. As China is the world's largest producer and consumer of formaldehyde, occupational exposure to formaldehyde may pose potential health risks to workers. We aimed to describe occupational exposure to formaldehyde over time in China.</p><p><strong>Methods: </strong>Occupational formaldehyde exposure measurements were extracted from Chinese and English scientific publications as well as routine occupational hazard monitoring datasets. A weighted mean concentration was calculated by occupation and industry.</p><p><strong>Results: </strong>We extracted over 20,447 individual measurements from 73 industries and 70 occupations during 1979 to 2023 across China. The majority of measurements (19%) were from the industry \"Manufacture of veneer sheets and wood-based panels,\" with a pooled mean task-based concentration of 0.69 (0.02 to 4.98) mg/m3. Among occupations with over 200 individual measurements and a pooled weighted mean concentration of 0.5 mg/m3 or higher, \"Metal moulders and coremakers\" has the highest task-based concentration, at 1.40 (0.04 to 1.99) mg/m3. Formaldehyde exposure levels varied across occupations and changed over time. Before 1990, the overall pooled mean (range) task-based concentration was 1.60 (0.15 to 6.14) mg/m3, decreasing to 0.41 (0.00 to 12.0) mg/m3 from 2011 onward.</p><p><strong>Conclusions: </strong>Occupational formaldehyde exposure in China has shown a declining trend over the past decades but remains high in certain occupations. Identifying high-risk industries and occupations can inform the development of targeted interventions and regulations to mitigate formaldehyde exposure. Furthermore, the presented exposure data can contribute to better exposure assessment in epidemiological investigations.</p>","PeriodicalId":8362,"journal":{"name":"Annals Of Work Exposures and Health","volume":" ","pages":"808-819"},"PeriodicalIF":2.1,"publicationDate":"2025-09-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144635989","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Mechanisms leading to occupational oral exposure: a systematic review and meta-analysis.","authors":"Marlene Dietz, Anke Kahl, Urs Schlüter","doi":"10.1093/annweh/wxaf042","DOIUrl":"10.1093/annweh/wxaf042","url":null,"abstract":"<p><strong>Introduction: </strong>In addition to inhalation and dermal exposure, also oral exposure is relevant in the workplace, even though this exposure route is most often neglected. In order to improve the understanding of occupational oral exposure, a systematic identification of mechanisms leading to inadvertent ingestion in the workplace is needed, including the transfer of chemicals and the contribution of aerosols.</p><p><strong>Methods: </strong>A systematic literature search was conducted according to the PRISMA method including 5 databases and 9 institutional websites. Information from the included studies was extracted in concept matrices and further analyzed.</p><p><strong>Results: </strong>Overall, 175 suitable publications were selected. Identified mechanisms leading to oral exposure were the transfer of chemicals, eg, from hands to mouth, and contributions from aerosols. Transfer influencing parameters were categorized as environmental, substance-specific, transfer pathway, surface, contact, or skin characteristics.</p><p><strong>Discussion: </strong>Even though oral exposure was mainly investigated for children so far, similar mechanisms can lead to oral exposure in adults. Although the parameters characterizing the transfer of chemicals were identified and categorized, inconsistencies in nomenclature were identified, and correlations between parameters and transfer efficiencies often remained unclear.</p><p><strong>Conclusions: </strong>The transfer of hazardous substances and the contribution of aerosols were identified as mechanisms of oral exposure. Transfer parameters and the interplay between particles from aerosols and oral exposure were discussed.</p>","PeriodicalId":8362,"journal":{"name":"Annals Of Work Exposures and Health","volume":" ","pages":"798-807"},"PeriodicalIF":2.1,"publicationDate":"2025-09-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12463556/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144706092","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Wildland firefighter exposure and female cancer risk: currently available evidence.","authors":"Kathleen Navarro DuBose, Megan Saylors, Pujeeta Chowdhary, Jessica Trowbridge","doi":"10.1093/annweh/wxaf048","DOIUrl":"10.1093/annweh/wxaf048","url":null,"abstract":"<p><p>The James M. Inhofe National Defence Authorization Act for Fiscal Year 2023 established that certain illnesses and diseases are to be deemed as proximately caused by employment in federal fire protection activities. However, cancers affecting female wildland firefighters were not included on this list and are recommended for further evaluation. We present the best available scientific evidence for the risk of breast and gynaecological cancers associated with exposures that are commonly measured in the wildland fire environment, including benzene, polycyclic aromatic hydrocarbons, and particulate matter. Epidemiology and experimental studies assessing these exposures have reported an increased risk for female breast and gynaecological cancers in other occupations or from indoor sources and the ambient environment (ie air pollution). Currently, there are 29 individual states in the United States that have laws that establish a presumption that female cancers contracted by firefighters are the result of occupational exposure. We highlight the link between common carcinogen exposures measured in the wildland fire environment with the risk of female cancers, which should be considered when evaluating the scientific evidence available for the inclusion of these cancers to be deemed as proximately caused by wildland firefighting.</p>","PeriodicalId":8362,"journal":{"name":"Annals Of Work Exposures and Health","volume":" ","pages":"791-797"},"PeriodicalIF":2.1,"publicationDate":"2025-09-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12463555/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144940563","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Inflammatory responses of inhalable aerosols from powder food industry in THP-1 cells.","authors":"Christine Darbakk, Raymond Olsen, Solveig Krapf, Pål Graff","doi":"10.1093/annweh/wxaf041","DOIUrl":"10.1093/annweh/wxaf041","url":null,"abstract":"<p><strong>Background: </strong>Occupational exposure to inhalable aerosols and airborne particles in the food production industry is associated with an increased risk of respiratory diseases, including asthma and chronic obstructive pulmonary disease (COPD). This study aims to investigate the inflammatory potential of inhalable aerosols collected from various food production environments and work tasks by assessing the concentrations of cytokines using an in vitro assay.</p><p><strong>Methods: </strong>The inflammatory response, as measured by the production of inflammatory cytokines tumor necrosis factor-alpha (TNF-α), interleukin 1β (IL-1β), IL-2, IL-4, IL-6, IL-8, IL-10, and IL-12, was determined using human macrophages derived from THP-1 monocytic cells. These cells were exposed to inhalable aerosol samples from 12 dry powder food processing plants. Cytokine concentrations were quantified using a Luminex assay.</p><p><strong>Results: </strong>This study identified statistically significant variations in in vitro cytokine responses across different production types and work tasks, emphasizing the diverse inflammatory potential of workplace aerosols. Furthermore, a dose-dependent relationship was observed for TNF-α, IL-8, IL-2, and IL-1β, suggesting that aerosol mass plays a role in immune activation. After normalizing cytokine concentrations to aerosol mass, variations in the intrinsic potential of aerosols were observed, indicating that aerosols generated during dry powder food production have differing capacities to induce an inflammatory response.</p><p><strong>Conclusions: </strong>This study has demonstrated that the inflammatory potential of inhalable aerosols collected from various food production environments can be assessed by measuring cytokine concentrations using an in vitro assay. Although cytokine concentrations were generally low, weighing and mixing food ingredients, and environments like coffee, spice, and powdered consumer product production, and bakeries exhibited elevated concentrations of inflammatory cytokines, potentially indicating a higher risk for workers in these settings.</p>","PeriodicalId":8362,"journal":{"name":"Annals Of Work Exposures and Health","volume":" ","pages":"868-882"},"PeriodicalIF":2.1,"publicationDate":"2025-09-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12463558/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144607258","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Are we underestimating exposures from NORM dust?","authors":"Gregory Stanley Hewson, Martin Ian Ralph, Marcus Cattani","doi":"10.1093/annweh/wxaf043","DOIUrl":"10.1093/annweh/wxaf043","url":null,"abstract":"<p><p>The inhalation of dust containing naturally occurring radioactive materials (NORM) associated with mining and mineral processing operations may lead to potential long-term health impacts, including cancer and chronic lung disease, due to alpha particle-emitting radionuclides. This study evaluates the effectiveness of air sampling strategies used to estimate radiation doses from NORM exposure, with a focus on the Western Australian minerals industry. The objectives were to review current sampling and analysis protocols, identify factors contributing to over- or underestimation of dose, and propose adjustments to improve intake assessments. A review of research and guidelines applicable to NORM dust exposure was conducted, and the sampling efficiency of the government-recommended 7-hole and IOM sample heads was compared, considering measured dust particle size distributions. Key inhalation-related parameters, including use of similar exposure group (SEG) mean concentrations, worker breathing rates, median dust particle size, and intake-to-dose conversion factors, were analysed to assess their influence on intake calculations. The findings indicate that use of the 7-hole sampler, currently recommended by local guidelines, may underestimate airborne radioactivity concentrations by 2-fold or more, primarily due to reduced sampling efficiency for larger particles. Standard default assumptions for breathing rates and aerosol characteristics used to convert the measured concentrations to intake and dose may further contribute to underestimation. This study recommends updating air sampling methods and dose assessment protocols to better align with workplace-specific exposure conditions and improve worker health protection in NORM industries.</p>","PeriodicalId":8362,"journal":{"name":"Annals Of Work Exposures and Health","volume":" ","pages":"820-831"},"PeriodicalIF":2.1,"publicationDate":"2025-09-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12463559/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144783360","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Asbestos bodies and amphibole fibres in the lung: do the Helsinki criteria need an update?","authors":"Pietro Gino Barbieri, Anna Benedetta Somigliana, Anna Muran, Donatella Calligaro, Ugo Fedeli, Paolo Girardi, Dario Consonni","doi":"10.1093/annweh/wxaf047","DOIUrl":"10.1093/annweh/wxaf047","url":null,"abstract":"<p><strong>Background: </strong>Since the 1980s, lung fibre burden analysis has been used in reconstructing past exposure to asbestos and in estimating the dose-response relationship for asbestos-related cancers.</p><p><strong>Objective: </strong>The objective of this study was to evaluate the validity (sensitivity and specificity) of the reference values proposed by the Helsinki Consensus Documents in 1997 and 2014 to assign asbestos exposure.</p><p><strong>Methods: </strong>Counts of asbestos bodies (AB) and amphibole asbestos fibres (AAF) in dry lung tissue samples performed by the ARPA Electron Microscopy Laboratory in Milan from 2009 to 2020 have been used to assess the discriminating performance between asbestos exposure and background exposure. For each sample/individual, we retrieved information on disease diagnosis and on asbestos exposure at work or in other settings. We calculated sensitivity and specificity using either Helsinki criteria (1000+ AB or 1,000,000+ AAF >1 µm per gram of dry lung tissue) or different optimal statistical cut-points chosen on the basis of three statistical methods.</p><p><strong>Results: </strong>From the original list of 822 samples, we selected samples from 563 individuals with information on disease (325 with mesothelioma, 158 with lung cancer, 24 with asbestosis or pleural plaques, and 56 without asbestos-related diseases) and with information on asbestos exposure. The number of subjects with a history of asbestos exposure was 507, 478 occupationally exposed and 29 with familiar or environmental exposure. The 56 individuals without asbestos-related diseases (of whom 53 were included in a previous publication on background asbestos exposure) were taken as \"unexposed.\" The estimated (rounded) optimal cut-points were 600 AB and 300,000 AAF with all three statistical methods. The Helsinki criteria had very good specificity (1 for AB and 0.95 for AAF), and good sensitivity (0.89) for AB, while sensitivity was quite low for AAF (0.67, implying one third of false negatives). The optimal statistical cut-points showed higher sensitivity for AB (0.94) and much better sensitivity for AAF (0.85). In sub-analyses, we found that the Helsinki criteria had good/sufficient sensitivity only among 249 highly exposed shipyard workers, not among 258 individuals with lower exposure; the optimal statistical cut-points yielded higher sensitivity, especially in lower-exposed individuals.</p><p><strong>Conclusions: </strong>Based on a large sample size, we have shown good sensitivity for AB but very low sensitivity for AAF using Helsinki criteria for the attribution of exposure to asbestos. We propose to adopt lower values (600 AB or 300,000 AAF), because they would avoid a large proportion of false negatives. We remind that lung fibre burden analysis should be viewed as a complement (not a substitute) for a carefully collected lifetime job history.</p>","PeriodicalId":8362,"journal":{"name":"Annals Of Work Exposures and Health","volume":" ","pages":"832-842"},"PeriodicalIF":2.1,"publicationDate":"2025-09-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144940536","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Optimization of the measurement method for airborne endotoxins in workplace atmospheres: experiments using laboratory-generated bioaerosols.","authors":"Pauline Loison, Lise Alonso, Xavier Simon","doi":"10.1093/annweh/wxaf057","DOIUrl":"10.1093/annweh/wxaf057","url":null,"abstract":"<p><p>Endotoxins are components of the outer membrane of bacteria that can become airborne during aerosol-generating work activities and cause adverse effects on workers' health. Filtration is the sampling method recommended by the EN 14031 standard for endotoxin measurements in workplace atmospheres. However, there are still differences in terms of practice regarding certain parameters of the measurement method. Thus, the storage of samples, the method of endotoxin extraction from the filter, and the type of filter are some parameters that still need to be studied to improve endotoxin recovery. For this purpose, laboratory experiments were performed based on 19 independent generations of an endotoxin aerosol coming from a suspension of 3 cultivable Gram-negative bacteria. Using a fix sampling time of 1 h, this experimental bioaerosol allow covering endotoxin concentrations from ~ 10 to ~ 104 EU/m3. Using the kinetic chromogenic LAL (Limulus Amebocyte Lysate) assay, our results show that a better recovery of endotoxins is achieved using 5 mL of pyrogen-free water compared to 10 mL, especially for glass fiber filters, with no change when the agitation time is reduced from 60 to 20 min. Except for polyvinylchloride, the type of filter (polycarbonate, Teflon, or glass fiber) does not have a great influence on the concentrations measured. However, PVC filters systematically gave a lower endotoxin concentration than the others. Finally, compared to the immediate processing of the cassette, storage of the samples at room temperature is possible for up to 8 d after sampling without altering the amount of endotoxin measured. These improvements make the results of the endotoxin concentration more robust and will help to make this measurement method more readily usable, especially with the simplification of the protocol steps and storage, providing a greater flexibility for analysts.</p>","PeriodicalId":8362,"journal":{"name":"Annals Of Work Exposures and Health","volume":" ","pages":"883-895"},"PeriodicalIF":2.1,"publicationDate":"2025-09-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145013747","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Research training in occupational health and hygiene-design and pilot study.","authors":"Dino Pisaniello, Mila Tejamaya, Abdul Kadir, Yichao Li, Yonatal Tefera, Sharyn Gaskin","doi":"10.1093/annweh/wxaf061","DOIUrl":"https://doi.org/10.1093/annweh/wxaf061","url":null,"abstract":"<p><strong>Introduction: </strong>Research training and research collaboration have been identified as a means of improving the standing and impact of occupational health and hygiene (OHH) professionals, especially in rapidly industrializing countries. The 2 key measures of research achievement relate to publication in high-impact (Q1) peer-reviewed journals and awarding of competitive research grants. However, there appears to be little formal research training guidance in the OHH field. In order to address the OHH training need, 2 introductory modules addressing publications and grants were developed by the University of Adelaide and the University of Indonesia and trialled in Indonesia.</p><p><strong>Methods: </strong>The Carpe Diem course design approach, with team-based storyboarding, was used. The training was delivered in hybrid mode to postgraduate and PhD students and early career researchers. The modules provided a focus on the value and context of OHH research and key elements scrutinized by editors, reviewers, and selection panels. Characterization of research \"players,\" gamification and storytelling were used to enhance interest amongst the relatively young audience.</p><p><strong>Results: </strong>Feedback from participants was positive, including design, interest, and meeting expectations. In an online survey, respondents stated that they would attend a similar training activity, and 96% would recommend this training to others.</p><p><strong>Discussion and conclusions: </strong>This research training activity is the first to focus on OHH research, and was successfully piloted in a country where industry and occupational hygiene are rapidly growing. Young researchers appreciated the novel learning design. Research training in developing countries may assist in making untapped exposure data available, expanding and enriching the OHH literature.</p>","PeriodicalId":8362,"journal":{"name":"Annals Of Work Exposures and Health","volume":" ","pages":""},"PeriodicalIF":2.1,"publicationDate":"2025-09-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145102579","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"What does good health look like? Development of leading occupational health performance indicators.","authors":"Carmen Naylor, Soraya Canvin, Luke Dunk, Vinod Gopaldasani, Adelle Liebenberg, Gary Lux, Fiona Macfarlane, Shilpa Panyam, Vanessa Sharp, Ajay Thomas, Elizabeth Uru, Jane Louise Whitelaw","doi":"10.1093/annweh/wxaf050","DOIUrl":"https://doi.org/10.1093/annweh/wxaf050","url":null,"abstract":"<p><strong>Background: </strong>Occupational Health and Safety (OHS) performance indicators are important to ensure effective management and contribute to organizational decision-making processes regarding health risk mitigation strategies. Recently, the resurgence of \"black lung\" and silicosis have increased awareness of work-related health impacts on workers and industry. Occupational health impacts are often under-reported compared to occupational safety impacts. Where they are addressed, the emphasis is typically on lagging indicators such as illness and disease rates. The inadequacy of lagging indicators such as workplace compensation statistics in revealing the full extent of worker illness and disease is widely acknowledged. A framework of leading indicators could provide workplaces with tools that can measure occupational health outcomes more effectively, allowing for early intervention and risk mitigation.</p><p><strong>Method: </strong>This study aims to identify reliable leading health indicators that can support workplaces to identify and manage risk factors that impact worker health, using a mixed-method review approach. Initially, a literature review to identify and rate the quality of key occupational health indicators was conducted, followed by a qualitative survey to collect stakeholder feedback. Indicators were stratified for quality and type (leading or lagging), in the categories of leadership, strategy, organization, employees, and partnership. The survey results were collated to reflect categories and sub-categories of Occupational Health and Safety (OHS) management system areas.</p><p><strong>Results: </strong>Of the 153 leading health performance indicators that were identified through the literature, 28 (18%) were evaluated as high quality, 80 (52%) as medium quality, and 45 (29%) as low quality. A total of 106 lagging indicators were extracted, 42 rated as high quality (40%), 39 (37%) as medium quality, and 25 (24%) as low quality. Results of the data review indicated that occupational health performance indicators centred on risk control systems (n = 7; 25%) and communication (n = 4; 14%) were rated as higher quality leading indicators. High-quality performance indicators pertaining to employees (competence, awareness, and involvement) were lacking (n = 2; 7%). A framework of leading indicators that can be used by companies to evaluate and ensure health risks are controlled is proposed.</p><p><strong>Conclusion: </strong>To effectively address occupational health risks, including injuries and illnesses that develop over time due to hazardous exposures, it is essential to integrate OHS metrics as a core component of health and safety management systems. This research established a baseline framework to assist the industry in establishing key occupational health performance objectives enabling them to achieve their duty of care to protect the health of workers.</p>","PeriodicalId":8362,"journal":{"name":"Annals Of Work Exposures and Health","volume":" ","pages":""},"PeriodicalIF":2.1,"publicationDate":"2025-09-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145091100","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}